Individual
MRS. ALLYSSA MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A
Contact information
Practice address
687 LEE RD, ROCHESTER, NY 14606-4257
(585) 458-7910
Mailing address
82 SANDSTONE DR, ROCHESTER, NY 14616-3404
(585) 415-1283
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007533-1
NY
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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